1. Field of the Invention
The present invention relates to heart catheterization procedures, and more specifically to right heart catheterization procedures. The present invention provides a torque for use in right heart catheterization procedures to apply rotational force to a right heart catheter to incrementally advance the right heart catheter through the arteries and valves of the heart during a right heart catheterization procedure. The torque of the present invention provides incremental advancement of the right heart catheter, which allows a physician to have more control over the movement of the right heart catheter over manual rotation and advancement by the physician, as is currently practiced.
2. Description of the Related Art
Right heart catheterization is a medical procedure commonly used to evaluate the blood pressure in the right side of a patient's heart and in his or her lungs. The procedure allows a physician to diagnose or evaluate the existence or progression of various conditions such as pulmonary hypertension, heart failure, congenital heart failure, valveular heart disease/malfunction or cardiomyopathy.
Right heart catheterization typically involves inserting a right heart catheter into the iliac vein of a patient and manually rotating and pushing the right heart catheter through the venous system while monitoring the location of the catheter using fluoroscopic x-ray. The right heart catheter is manually guided by the physician through the inferior vena cava into the right atrium of the patient's heart. From there, the physician continues to manually advance the right heart catheter through the tricuspid valve into the right ventricle, and on through the pulmonary valve into the pulmonary artery.
The catheter is attached to one or more hemodynamic monitors known in the art of right heart catheterization to take several pressures during the procedure. For instance, once the right heart catheter enters the right atrium, the right atrium pressure is recorded. As the right heart catheter is positioned through the tricuspid valve and into the right ventricle, the right ventricular pressure is obtained. As the catheter passes through the pulmonary valve into the pulmonary artery, the mean pulmonary pressure in the pulmonary trunk is obtained. Finally, once the right heart catheter is positioned in the pulmonary artery, the catheter is inflated to seal the capillaries in the lungs and the capillary wedge pressure is obtained.
The manual manipulation of the right heart catheter through the right heart and arteries is guided by fluoroscopic x-ray. In the majority of right heart catheterizations, access is obtained through the iliac vein and the right heart catheter, which is a curved and flexible balloon device known and typically used by one of ordinary skill in the art of right heart catheterization, travels against its curvature through the inferior vena cava, to reach the right atrium. Once in the right atrium, the right heart catheter has to be turned clockwise externally to aim towards the tricuspid valve, which is challenging when done manually. Once the right heart catheter passes through the tricuspid valve, it is manually turned upward towards the right ventricular track and then advanced into the pulmonary artery. All of this manual maneuvering of the right heart catheter is challenging and often requires prolonged exposure to fluoroscopy with associated radiation due to the need to use fluoroscopic x-ray to monitor the positioning of the right heart catheter. The prolonged exposure to radiation is problematic in today's medical climate, as physicians are looking for ways to decrease exposure of their patients to radiation.